Individual provider Active NPI

Evelyn R Mote, M.D.

  • Family Medicine Physician
  • Moraine, OH
National Provider Identifier
1528049053
Registry record updated Jan 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35062357 Issued in OH
Practice address
3033 Kettering Blvd Ste 100
Moraine, OH 45439-1948
Phone
(937) 293-2133
Fax
(855) 252-2435
NPI assigned
Nov 10, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35062357 OH Primary

Addresses

Primary practice location

3033 Kettering Blvd Ste 100
Moraine, OH 45439-1948

Mailing address

PO Box 639295 Dept 93394
Cincinnati, OH 45263-9295
Phone (937) 293-2133

Other practice location 1

1250 National Rd
Suite400
Clayton, OH 45315-9505
Phone (937) 836-5165

Other practice location 2

50 E Rivercenter Blvd Ste 434
Covington, KY 41011-1660
Phone (833) 358-2278

Other practice location 3

5151 Pfeiffer Rd Ste 350
Blue Ash, OH 45242-4854
Phone (833) 358-2036

Other identifiers 1

IdentifierTypeStateIssuer
2601947MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051011000249 OH Practitioner - Family Practice 3678598422 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Ohio State University College of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Vpa PCGroup PAC ID 9234041948, 181 clinicians

Practice addresses (Care Compare)

Moraine, OH 45439
Phone (937) 293-2133

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35062357OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vpa PC Family Medicine CurrentSince Feb 1, 2025 Accepting new patients
Vpa PC Family Medicine Current Accepting new patients
Vpa PC Family Medicine Current Accepting new patients
Vpa PC Family Medicine CurrentSince Feb 1, 2025 Accepting new patients
Summit Medical Group, PLLC Family Medicine PastSince Dec 1, 2019 Accepting new patients

Locations

355 E Campus View Blvd
Ste 180
Columbus, OH 43235
Phone (614) 523-2155

3033 Kettering Blvd
Ste 100
Moraine, OH 45439
Phone (937) 293-2133

Interoperability endpoints

  • Direct secure messaging: emote@landmarkhealth-direct.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1528049053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 639295 DEPT 93394",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452639295",
            "telephone_number": "937-293-2133",
            "fax_number": "855-252-2435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3033 KETTERING BLVD STE 100",
            "city": "MORAINE",
            "state": "OH",
            "postal_code": "454391948",
            "telephone_number": "937-293-2133",
            "fax_number": "855-252-2435"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1250 National Rd",
            "address_2": "SUITE400",
            "address_purpose": "LOCATION",
            "city": "Clayton",
            "state": "OH",
            "postal_code": "453159505",
            "country_code": "US",
            "telephone_number": "937-836-5165",
            "fax_number": "937-836-6709",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "50 E Rivercenter Blvd Ste 434",
            "address_purpose": "LOCATION",
            "city": "Covington",
            "state": "KY",
            "postal_code": "410111660",
            "country_code": "US",
            "telephone_number": "833-358-2278",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5151 Pfeiffer Rd Ste 350",
            "address_purpose": "LOCATION",
            "city": "Blue Ash",
            "state": "OH",
            "postal_code": "452424854",
            "country_code": "US",
            "telephone_number": "833-358-2036",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOTE",
        "first_name": "EVELYN",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-10",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35062357",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2601947",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moraine, OH

Sources for this page

Verify at the official NPI Registry.